2025 CPT code 98975
(Revised) Effective Date: N/A Revision Date: N/A Medicine Services and Procedures > Non-Face-to-Face Nonphysician Services Feed
Remote therapeutic monitoring (e.g., therapy adherence, therapy response); initial set-up and patient education on use of equipment.
Medical necessity for RTM should be established by the ordering physician or qualified healthcare professional. It should be justified by the patient's clinical condition and the need for remote monitoring to effectively manage their therapy and track progress towards treatment goals. Documentation should support the rationale for RTM.
A provider (such as a nurse, technician, or therapist) performs the initial setup of the RTM equipment and educates the patient on its use, following an order from a physician or other qualified healthcare professional. The device used must be a medical device as defined by the FDA.
In simple words: This code covers the initial setup and training for using remote monitoring equipment at home. This equipment helps doctors keep track of how you're doing with your therapy, like if you're taking your medications as prescribed or if your breathing or movement is improving.A healthcare professional will set everything up and teach you how to use it.
This code represents the initial setup and patient education for remote therapeutic monitoring (RTM) equipment.The RTM process uses medical devices to collect therapeutic data remotely, which is then used to monitor patient response to therapy and adjust treatment plans accordingly. Examples of RTM include monitoring therapy (medication) adherence and response, respiratory system status, musculoskeletal system status, and cognitive behavioral therapy.The service includes educating the patient on the proper use of the equipment, ensuring they can effectively collect and transmit the necessary data.This code is reported once per episode of care, which starts when RTM begins and ends when treatment goals are met. Note: This code should not be reported for monitoring periods less than 16 days.
Example 1: A patient with chronic obstructive pulmonary disease (COPD) is prescribed RTM to monitor respiratory system status. The provider sets up the monitoring equipment (e.g., spirometer, pulse oximeter), educates the patient on its use, and explains the data transmission process., A patient undergoing physical therapy for a knee injury is prescribed RTM to track their progress. The provider sets up a wearable sensor or mobile app, explains how to use it to record exercises and report pain levels, and demonstrates how to submit the data for remote monitoring., A patient begins a new medication regimen for hypertension and is prescribed RTM to monitor medication adherence. The provider sets up a smart pill dispenser or mobile app, instructs the patient on how to use it, and confirms the patient understands how to transmit adherence data.
Documentation should include the type of RTM equipment used, details of the patient/caregiver education provided, confirmation of the data transmission process, and the start date of monitoring. The order from the physician or qualified healthcare professional should also be documented.
** As of December 1, 2024, the examples of respiratory and musculoskeletal system monitoring, previously included in some descriptions, have been removed for clarity. However, these conditions remain valid applications for RTM using code 98975, along with therapy adherence/response and cognitive behavioral therapy monitoring.
- Specialties: This code is applicable across various medical specialties, including but not limited to: pulmonology, cardiology, physical therapy, occupational therapy, and behavioral health.
- Place of Service:Office, Home, Outpatient Hospital, and other places where RTM setup and patient education can occur.